与动脉静脉通道创建取消相关的因素
Andrea Alonso1, Jingtong Huang1, Carlos Fairen Oro1
1Division of Vascular and Endovascular Surgery, Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
Journal of vascular surgery
|June 8, 2025
概括
动脉静脉接入取消延迟了血液透析,影响了患者的护理. 解决急性疾病,后勤问题和准备可以减少延迟并改善病患者的治疗结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血管外科 血管外科
- 医疗保健管理的管理
背景情况:
- 创建动脉静脉 (AV) 接入对于永久性血液透析 (HD) 接入至关重要.
- 取消AV访问程序可能会导致HD访问建立的重大延迟.
- 这些延迟可能会对患者的治疗结果和医疗保健效率产生负面影响,特别是在医院环境中的安全网.
研究的目的:
- 为了确定AV访问创建取消率.
- 确定导致这些取消的主要因素.
- 评估取消对后续的HD接入机构和患者管理的影响.
主要方法:
- 在一个学术医疗中心 (2018-2024) 的AV访问创建的回顾性审查.
- 分析前一天和一周安排的门诊和住院手术取消原因.
- 多变量分析以确定同一天门诊取消预测因素.
主要成果:
- 17.7%的AV访问创建在同一天被取消,7.7%在前一周被取消.
- 常见的取消原因包括急性疾病,慢性病并发症,后勤问题和准备不足.
- 同一天的门诊取消与下午开始时间相关 (OR,3.09;P <.001).
- 很大一部分患者 (14.3%在同一天,16.7%在一周前) 在取消治疗后的6个月内没有获得永久性HD接入,有些人需要临时导管.
结论:
- 取消影响约四分之一的预定AV访问程序.
- 导致取消的关键因素包括急性疾病,控制不良的CKD并发症和后勤挑战.
- 建议采取有针对性的干预措施,如计划优化和加强手术前准备,以减少取消手术并提高血液透析护理质量.
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